NPIMap

Organization Active NPI

Well Care Home Health of Forsyth, Inc.

  • Home Health Agency
  • Kernersville, NC
National Provider Identifier
1548068687
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
WELL CARE HOME HEALTH OF FORSYTH, INC.
Practice address
500 Pineview Dr Ste 117
Kernersville, NC 27284-3813
Phone
(888) 815-5310
Fax
(877) 399-3552
NPI assigned
Mar 5, 2025
Last updated
Mar 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel Grayson Thompson, RN
Title
VP, Compliance and Quality
Phone
(910) 622-5491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

500 Pineview Dr Ste 117
Kernersville, NC 27284-3813

Mailing address

131 Racine Dr Ste 201
Wilmington, NC 28403-8752
Phone (910) 362-9405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250925000514 NC Part A Provider - Home Health Agency 9133624679 Practice locations: Kernersville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548068687. Details of each certification follow.

Home health agency certification: CCN 347341

Legal name
WELL CARE HOME HEALTH OF FORSYTH, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 17, 2026
Last certification
Jan 29, 2026
Organization structure
CorporationProprietary
Enrollment address
500 Pineview Dr
Ste 117
Kernersville, NC 27284-3813

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2330627Well Care Home Health of Forsyth500 Pineview Drive, Kernersville, NC 27284Certificate of waiverSep 18, 2027

National Provider Directory

National Provider Directory

Locations

500 Pineview Dr
Ste 117
Kernersville, NC 27284
Phone (888) 815-5310

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Chadwick Individual Corporate OfficerChief Financial Officer Mar 25, 2025
Operational/Managerial ControlChief Financial Officer Mar 25, 2025
Well Care Health, Inc. Organization, Wilmington, NC LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 25, 2025 100%
Daniel Thompson Individual W-2 Managing EmployeeVP, Compliance and Quality Mar 25, 2025
Zachary Long Individual Corporate OfficerChief Executive Officer Mar 25, 2025 100%
Long Family Ventures, LLC Organization, Raleigh, NC LLC 5% Or Greater Indirect Ownership Interest Mar 25, 2025 100%

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1548068687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 RACINE DR STE 201",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038752",
            "telephone_number": "910-362-9405",
            "fax_number": "877-399-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PINEVIEW DR STE 117",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272843813",
            "telephone_number": "888-815-5310",
            "fax_number": "877-399-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL CARE HOME HEALTH OF FORSYTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "GRAYSON",
        "authorized_official_title_or_position": "VP, COMPLIANCE AND QUALITY",
        "authorized_official_telephone_number": "910-622-5491",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.